Objective To investigate the effect of Colchicine and Febuxostat combined with external application of Phellodendra and Rhubarb in the treatment of elderly patients with acute gouty arthritis.Methods A total of 104 elderly patients with acute gouty arthritis admitted to Hongqi Hospital Affiliated to Mudanjiang Medical University from February 2019 to July 2020 were selected as the research objects and divided into the control group, observation Ⅰ,Ⅱ, Ⅲgroup by random number table method, with 26 cases in each group.Control group was treated by oral colchicine treatment, observation Ⅰgroup was treated by oral Colchicine and Febuxostat, observation Ⅱgroup was treated by oral Colchicine combined with external application of Phellodendra and Rhubarb, observation Ⅲgroup was treated by oral Colchicine and Febuxostat combined with external application of Phellodendra and Rhubarb.After treatment, the difference of joint circumference, blood uric acid level and treatment effect of four groups were compared.Results After treatment, the joint diameter differences of the observation Ⅰ, Ⅱgroup were smaller than those of the control group, and the joint diameter difference of the observation Ⅲgroup was smaller than that of the control group, observation Ⅰ, Ⅱgroup, the differences were statistically significance (P＜0.05).The levels of blood uric acid in observation Ⅰ, Ⅲgroup were lower than those in control group and observation Ⅱgroup, and the differences were statistically significant (P＜0.05).The total effective rate of observation Ⅲgroup was higher than that in the control group, and the difference was statistically significant (P＜0.05).Conclusion Oral Colchicine And Febuxostat combined with external application of Phellodendron and Rhubarb can effectively improve the therapeutic effect of elderly patients with acute gouty arthritis.